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目的研究不同手术方式治疗食管癌后并发症及吻合口瘘的发生情况。方法选择某院2004年6月～2007年6月186例采用两种手术方式治疗的食管癌患者,根据采用的手术方式分为两组,采用胃食管颈部吻合的患者84例为颈部吻合组,采用胸腔内吻合的102例患者为胸腔内吻合组。研究不同手术方式治疗后吻合口狭窄、吻合口瘘、乳糜胸等并发症的发生率及患者生存率。结果颈部吻合组发生吻合口狭窄1例,吻合口瘘2例,乳糜胸3例,并发症发生率为7.14%;胸腔内吻合组发生吻合口狭窄11例,吻合口瘘9例,乳糜胸7例,并发症发生率为26.47%;颈部吻合组并发症发生率明显低于胸腔内吻合组,两组比较差异有统计学意义(P﹤0.05);观察患者1年、3年、5年生存率结果显示,颈部吻合组生存率均高于胸腔内吻合组,两组比较差异有统计学意义(P﹤0.05)。结论经左颈.右胸.上腹正中三切口手术行胃食管颈部吻合术是治疗食管癌的有效手术方法,术后吻合口瘘发生率底,患者预后较好,符合肿瘤根治原则。
Objective To study the postoperative complications and esophagogastrostomy after different surgical procedures. Methods A total of 186 patients with esophageal cancer treated by two surgical procedures from June 2004 to June 2007 in our hospital were divided into two groups according to the operation method and 84 patients with gastroesophageal and cervical anastomosis underwent neck anastomosis Group, the use of intrathoracic anastomosis of 102 patients for intrathoracic anastomosis group. To study the incidence of complications such as anastomotic stenosis, anastomotic fistula, chylothorax and the survival rate of patients after different surgical methods were treated. Results There were 1 case of anastomotic stenosis, 2 cases of anastomotic fistula and 3 cases of chylothorax in the anastomosis group. The incidence of complications was 7.14%. There were 11 cases of anastomotic stenosis, 9 cases of anastomotic fistula, The incidence of complications in the neck anastomosis group was significantly lower than that in the thoracic anastomosis group, the difference was statistically significant (P <0.05). The patients were followed up for 1 year, 3 years and 5 years The annual survival rate showed that the survival rate of neck anastomosis group were higher than that of intrathoracic anastomosis group, the difference between the two groups was statistically significant (P <0.05). Conclusions The operation of gastroesophageal neck anastomosis through the left and right trochanter and the right middle abdomen incision is an effective surgical method for the treatment of esophageal cancer. The incidence of anastomotic fistula after surgery is good, and the prognosis is good, which accords with the principle of radical tumor.